| ObjectiveComparative analysis of the clinical efficacy and complications of nasal endoscopic transoral adenoid plasma ablation and craniopharyngeal fascia-occipital periosteal surface peelingMethodsA total of 231 surgical data and perioperative period data were collected from April 2020 to April 2021 in the Department of Otorhinolaryngology of Haoshui County People’s Hospital,and 123 cases of adenoidal hypertrophy were diagnosed from 36 months to 168 months,of which 108 cases of adenoidal dissection were performed by low-temperature plasma from the base of the pharynx to the surface of the occipital periosteum under oral and nasal endoscopy,and 123 cases were ablated to the root of the leaf-splitting tissue by oral and nasal endoscopic adenoids,and the two sets of data were controlled and analyzed.The clinical efficacy evaluation indicators include:(1)Surgical safety indicators: comparative analysis of nasal endoscopic transoral adenoid plasma ablation and craniopharyngeal fascia-occipital periosteal surface dissection of the two surgical methods of surgery time,intraoperative bleeding volume,postoperative pain and bleeding risk.(2)All patients were followed up after surgery to 6 months after surgery,and the OSA-18 scale and electronic nasopharyngoscopy were completed one month after surgery and 6 months respectively.The study was performed by IBM SPSS 24.0 software for statistical analysis,the measurement data following the normal distribution were described by mean ± standard deviation,the difference analysis between the two groups was analyzed by independent sample t-test,and the before-and-after different analysis at different time points was analyzed by paired sample t-test.The measurement data that did not follow the normal distribution were described by the median and quartile spacing,the Mann-Whitney U rank sum test was used for comparison between the two groups,and the Wilcoxon rank test was used for the paired sample comparison;Counting data are described using frequency numbers,and distribution difference analysis is performed using chi-square tests or Fisher’s exact probability method.The test level α = 0.05,with P<0.05 as statistically significant.ResultsIn this study,two groups of patients successfully removed adenoids during surgery,and there were no special cases such as forced abortation and poor postoperative prognosis during surgery.(1)Comparing the general conditions of the ablation group and the stripping group,the results showed that in addition to BMI,there was no statistically significant difference in the distribution of sex,age,weight,height,length of hospital stay,preoperative OSA-18 scale score and degree of nostril after adenoid blockage.(2)Analysis of the intraoperative situation of the ablation group and the stripping group: the surgical time was compared and analyzed,and the results showed that there was a statistical difference in the surgical time between the two groups,and the surgical time of the ablation group may be longer than that of the stripping group;The difference between intraoperative bleeding volume and intraoperative bleeding volume in the ablation group vs.intraoperative bleeding volume in the stripping group was statistically significant.(3)Analysis of the postoperative conditions of the ablation group and the dissection group: the pain after the 4th,5th and 6th days after the surgery in the detachment group and the pain cases after the 4th,5th and 6th days after the ablation group was statistically significant;The number of postoperative bleeding cases in the ablation group vs the number of postoperative bleeding cases in the dissection group were statistically significant;The electronic nasopharyngeal mirror was reviewed 30 days after the operation,and it was found that the scab shedding in the stripping group and the scab shedding in the ablation group 30 days after the peeling group were statistically significant.(4)In the general population,compared with before treatment,the difference in OSA-18 scale scores was statistically significant between 1 month after surgery and 6 months after surgery;The analysis of differences between the two groups of people in the stripping and ablation groups was performed,and the preoperative OSA-18 scale scores did not have statistical differences between the two groups.At 1 month postoperative and 6 months postoperatively,the difference between the two groups was statistically significant in the OSA-18 scale score,and the ablation scale score may be higher than that in the stripping group.(5)Speedman correlation analysis was used to explore the correlation between age,operation time and intraoperative bleeding volume in the two surgical methods,and to draw scatter plots.Whether in the ablation group or the stripping group,age may have a certain correlation with the duration of surgery;In the ablation group,age may have some correlation with the amount of bleeding during surgery.Conclusions1.Nasal endoscopic plasma ablation of oral adenoids to the root of the lobed tissue and the peeling of the surface from the craniopharyngeal fascia-occipital periosteum are safe and effective for the surgical method of excision of the adenoids.2.On the basis of no significant difference in the ratio,age,BMI index and preoperative OSA score between the two groups,the intraoperative bleeding volume and postoperative bleeding risk in the ablation group may be superior to the stripping group;Ablation may have advantages over dissection in terms of postoperative bleeding and postoperative pain.3.Nasal endoscopic transoral adenoid plasma ablation and craniopharyngeal fascia-occipital periosteal surface peeling are compared,and ablation may have advantages over dissection in postoperative bleeding and postoperative pain.Intraoperative bleeding volume and postoperative bleeding risk were lower in the ablation group compared to the stripping group.4.Compared with the two surgical modes of ablation group and peel group,there was a significant statistical difference in the operating time between the two groups,and the operation time of the ablation group may be higher than that of the peel group.Moreover,the speedman correlation analysis was used to explore age and operation time in the two surgical methods,and it was found that whether in the ablation group or the stripping group,age may have a certain correlation with the operation time.5.Hypothermia hypoplasmic adenoid surgery,which rapidly reduces the specific quality of life(OSA-18)score of children with obstructive sleep apnea disease and improves the quality of life of children,which has positive significance.In the general population,the difference in OSA-18 scale scores was statistically significant between 1 month after surgery and 6 months after surgery compared with before treatment.In the stripping and ablation groups,there was a statistically significant difference in OSA-18 scale scores between 1month postoperative and 6 months postoperatively compared with before treatment.6.The ablation group and the peel group had a postoperative OSA-18 scale score,and the OSA-18 scale score in the stripping group had an advantage over the ablation group in the postoperative and postoperative 6months,and the ablation OSA-18 scale score may be higher than that of the dissection group. |
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